Association between anticholinergic burden and dementia in UK Biobank
Jure Mur1,2,3, Tom C Russ3,4,5, Simon R Cox1
1Lothian Birth Cohorts Group Department of Psychology University of Edinburgh Edinburgh UK.
Insights
Anticholinergic burden (AChB) increases dementia risk, particularly with certain drug classes like antidepressants. This study highlights the need for detailed analysis of drug effects on dementia risk.
Area of Science:
- Pharmacology
- Neurology
- Epidemiology
Background:
- Previous research on anticholinergic drugs and dementia shows mixed results.
- Variability may stem from different measurement scales and drug class effects.
Purpose of the Study:
- To investigate the association between anticholinergic burden and dementia risk.
- To explore potential differences in risk across various drug classes.
Main Methods:
- Utilized Cox proportional hazards models on UK Biobank data (2000-2015).
- Included 171,775 participants with linked general practitioner prescription records.
- Calculated annual anticholinergic burden (AChB).
Main Results:
- Both anticholinergic burden (AChB) and its increasing trajectory predicted dementia.
- The association was significant for specific drug classes, including antidepressants, antiepileptics, and antidiuretics.
- Hazard ratio for AChB trajectory was 1.094 (95% CI: 1.068-1.119).
Conclusions:
- Heterogeneity in findings may be due to differential drug class effects.
- Further research is needed to detail these differences and assess the utility of a general AChB measure for dementia risk.
- Anticholinergic drug use, especially certain classes, is a significant factor in dementia risk.
Background:
Previous studies on the relationship between anticholinergic drugs and dementia have reported heterogeneous results. This variability could be due to different anticholinergic scales and differential effects of distinct classes of drugs.
Methods:
Using Cox proportional hazards models, we computed the association between annual anticholinergic burden (AChB) and the risk of dementia in UK Biobank with linked general practitioner prescription records between the years 2000 and 2015 (n = 171,775).
Results:
AChB according to most anticholinergic scales (standardized odds ratio range: 1.027-1.125) and the slope of the AChB trajectory (hazard ratio = 1.094; 95% confidence interval: 1.068-1.119) were predictive of dementia. However, the association between AChB and dementia held only for some classes of drugs, especially antidepressants, antiepileptics, and antidiuretics.
Discussion:
The heterogeneity in previous findings may partially be due to different effects for different classes of drugs. Future studies should establish differences in more detail and further examine the practicality of a general measure of AChB relating to the risk of dementia.
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